Aircraft manufacturer Boeing Comany is the latest mega employer claiming the Patient Protection and Affordable Care Act (also known as Obamacare) is part of why its employees will have to pay more for their medical benefits next year. In a letter mailed to employees late last week, Boeing said deductibles and copayments are going up significantly for some 90,000 non-union workers due in part to the effects of the new law. (source)Continued…

President Obama and his fellow Democrats who pushed the unpopular legislation through Congress have stated repeatedly that the law would bring down individuals’ costs for health insurance. Meanwhile the debate over the obscenely expensive bill raged on with Republican lawmakers and the majority of the American people speaking out against the far-reaching government power grab disguised as reform. Announcements like Boeing’s are proving the opposition right.

Boeing joins other companies like 3M which earlier this month announced it will stop offering its health insurance plan to their 23,000 retirees in response to Obamacare’s passage. (source)

While Boeing cited two additional reasons for the cost shift including untamed health care inflation and lifestyle issues such as being overweight, company spokeswoman Karen Forte said the company is concerned that its relatively generous plan will get hit with a new tax under the law in 2018.

Democrats are moral idiots who think, “Someone else will be paying for it, so it must be the right thing to do.”

Businesses are raising the costs employees will have to pay, or else they are simply dropping coverage altogether. And those businesses and most every single other business are holding back on hiring because of ObamaCare, massive and unnecessary regulations, taxes, and basically Barack Obama and the Democrat Party in general.

This whole ObamaCare thing is just working out great.

Democrats are refusing to talk about the massive boondoggle they cursed America with. Don’t you forget that curse when you vote in two weeks.

The American people will pay an additional one trillion dollars in taxes over ten years than they otherwise would have paid to finance the Democrats’ takeover of health care. That is a brutal fact.

When the Democrats say their bill is “deficit neutral” what they mean is that they made drastic cuts in the Medicare budget and drastic increases in our taxes in order to create the illusion that it was deficit neutral.

Here’s some more brutal facts that your mainstream media will not tell you about regarding health care.

The Democrats are irresponsibly and disingenuously claiming that the bill would cost $871 billion over 10 years. But that’s not what the CBO says. Rather, the CBO says that $871 billion would be the costs from 2010 to 2019 for expansions in insurance coverage alone. But less than 2 percent of those “10-year costs” would kick in before the fifth year of that span. In its real first 10 years (2014 to 2023), the CBO says that the bill would cost $1.8 trillion — for insurance coverage expansions alone. Other parts of the bill would cost approximately $700 billion more, bringing the bill’s full 10-year tab to approximately $2.5 trillion — according to the CBO.
In those real first 10 years (2014 to 2023), Americans would have to pay over $1 trillion in additional taxes, over $1 trillion would be siphoned out of Medicare (over $200 billion out of Medicare Advantage alone) and spent on Obamacare, and deficits would rise by over $200 billion . They would rise, that is, unless Congress follows through on the bill’s pledge to cut doctors’ payments under Medicare by 21 percent next year and never raise them back up — which would reduce doctors’ enthusiasm for seeing Medicare patients dramatically.

And what would Americans get in return for this staggering sum? Well, the CBO says that health care premiums would rise, and the Chief Actuary at the Centers for Medicare and Medicaid Services says that the percentage of the Gross Domestic Product spent on health care would rise from 17 percent today to 21 percent by the end of 2019. Nationwide health care costs would be $234 billion higher than under current law. How’s that for “reform”?

Even MoveOn.org says that the bill is “a massive giveaway” to private insurance companies. The CBO estimates that, from 2015-25, private insurers would receive $1.0 trillion in subsidies from the American taxpayer — the insurers’ apparent price for giving up their freedom and being controlled by the government. Congress would mandate that Americans buy the insurers’ product and would redirect massive sums of taxpayer money to make that mandate more feasible. So, if insurance companies are your idea of a worthy object of philanthropy, then Obamacare is for you.

And this is the bill that Ben Nelson has decided to support?

One hopes that Nebraska voters — and all other voters in other states who have sent Democrats to Washington — are making a list and checking it twice, keeping track of votes on Obamacare.

As Harry Reid keeps senators in session rather than letting them go home to be with their families and celebrate Christmas, it’s important to remember that this bill would not go into effect in any meaningful way until more than an Olympiad from now. Thus, it is the American voters — and not the current Democratic Congress or the current president — who will ultimately decide its fate. Providing reminders to representatives in both chambers of that in the coming days will be crucial to beating back the onslaught of proposed legislation that, even if it passes the Senate, would at least have to passed again by the House and would likely have to go back through both chambers in compromised form.

There’s a frightening game being played with the truth. And willingly or not, the CBO is helping the Obama administration lie to the American people.

A big part of the problem is that the CBO has to take Congress’ word for everything in their scoring – and the Congress (especially this Congress) is a bunch of liars.

If Congress has a huge spending bill, and tells the CBO that they will pay for it by picking the right numbers and hitting the mega-jackpot every year for the next 20 years, then the CBO must assume that the bill will be paid for – and thus “deficit neutral” in its scoring.

Maybe I’m not being clear enough. So I’ll provide another example. If Congress says that they will pay for their spending bill by summoning a winged fairy who will wave a magic wand and create a trillion dollars from nowhere, the CBO must count that trillion dollars in their scoring toward a “deficit neutral” bill.

Some have thought that Elmendorf was in fact intimidated, because their scores suddenly became much friendlier to ObamaCare. But I personally believe it was simply a matter of the White House learning how to write a bill so that it would appear “deficit neutral” in a CBO score. Democrats, in other words, learned how to use the right gimmicks to get the right results.

So if Congress says that it will increase taxes by a trillion dollars, then the CBO has to take it as gospel truth in its calculations. But the fact of the matter is that tax revenues go down dramatically as tax rates go up (and see here also) for the simple reason that more and more people change their behavior and start sheltering their assets. In the same way, when a bunch of new fees are imposed, people will start buying less and less of what will suddenly become more and more expensive.

The more of your own money you are allowed to keep, the harder you will work, and the more you will risk your money by investing. The more you are taxed, the more you will adjust your behavior by protecting what you have, and the less you will be willing to take risks for a shrinking reward.

Bottom line: the federal government will collect far less in revenue than it thinks it will. Revenues are already down dramatically as the White House and congressional Democrats have repeatedly vowed to end the Bush tax cuts (i.e. raise taxes) and increase taxes across the board.

In the same way, if Democrats tell the CBO that they will create savings by cutting the Medicare budget to the tune of half a trillion dollars and apply that “savings” to ObamaCare, then the CBO must assume that that will be the case.

It’s frankly difficult to believe that the Democrats will actually gut Medicare as they are saying they will do. Will they really take $500 billion from Medicare? Really? And utterly outrage seniors who have counted on that benefit for decades? If they do, they will pay dearly for it in every election until those seniors finally die. If they don’t, you can add at least half a trillion dollars to what the Democrats say their bill will cost.

The same thing applies to the “doctor fix.” Democrats will either follow through with their plan to make Medicare so expensive to doctors and hospitals that many medical professionals stop accepting it, or else they won’t. If they do, the Medicare system will collapse. If they don’t, then you can add hundreds of billions more to the cost of their health care plan.

“A plan to slash more than $500 billion from future Medicare spending — one of the biggest sources of funding for President Obama’s proposed overhaul of the nation’s health-care system — would sharply reduce benefits for some senior citizens and could jeopardize access to care for millions of others, according to a government evaluation released Saturday. The report, requested by House Republicans, found that Medicare cuts contained in the health package approved by the House on Nov. 7 are likely to prove so costly to hospitals and nursing homes that they could stop taking Medicare altogether.”

WASHINGTON – Senate Republicans forced Democrats to vote in favor of cutting billions from providers of home care for older people as partisan debate flared Saturday during a rare weekend session on President Barack Obama’s health care overhaul.

Obama planned to travel to Capitol Hill on Sunday to help Democrats resolve internal disputes that stand in the way of Majority Leader Harry Reid bringing the 10-year, nearly $1 trillion legislation to a vote.

Ahead of his visit, Republicans, bent on making Democrats cast politically risky votes, offered their third amendment in the debate so far showcasing more than $400 billion in cuts to projected Medicare spending that would pay for the bill, mostly for subsidies to help extend coverage to millions of uninsured.

Like the other two, this one went down to defeat, on a vote of 53 to 41. The measure by Sen. Mike Johanns, R-Neb., would have eliminated $42 billion in cuts over 10 years to agencies that provide home health care to seniors under Medicare.

Four moderate Democrats joined all Republicans present in voting for the amendment: Sens. Jim Webb of Virginia, Evan Bayh of Indiana, Blanche Lincoln of Arkansas and Ben Nelson of Nebraska.

Underscoring the pressures on the moderates, Lincoln, who faces a difficult re-election next year, initially cast a “no” vote with the Democratic majority but switched to “yes” in the course of the 15-minute vote. Republicans accused her of flip-flopping, but Lincoln said later that she changed her vote after considering how important home health care is to Arkansas.

“That’s why they give us 15 minutes,” said Lincoln.

The more consequential action was taking place behind closed doors Saturday as Democrats struggled to find a compromise on a proposed government insurance plan that would compete with private insurers. Lincoln and several other moderate Democrats are opposed to the government insurance plan in the bill, and Reid, D-Nev., doesn’t have a vote to spare in his 60-member caucus.

The Democrats’ logic is to replace a bankrupt government program that will only crash against the seniors it was supposed to cover with a vastly larger government program that will crash with a far larger implosion against everybody.

Seniors are going to die under the Democrats’ plan. The logic is unavoidable: 1) the plan calls for young, healthy people to buy expensive insurance policies – which they have never purchased before – in order to “spread out risks” for the entire system. 2) If they don’t purchase the coverage, they will be called upon to pay a fine. The problem is that the fine is much lower than the price of the insurance coverage. 3) Therefore young people largely WON’T purchase the insurance, and will instead pay the fine, knowing that since they CAN’T be rejected for any “pre-existing condition” (such as not being insured), they can’t be turned down if they get sick/injured and then need coverage. For what it’s worth, a lot of other adults will be encouraged to do the same thing. 4) Therefore, the Democrats’ plan will not raise nearly as much as they think. And 5) the need to severely ration care will be critical.

As Congress’s balance sheet drowns in trillions of dollars in new obligations, the political system will have no choice but to start making cost-minded decisions about which treatments patients are allowed to receive. Democrats can’t regulate their way out of the reality that we live in a world of finite resources and infinite wants. Once health care is nationalized, or mostly nationalized, medical rationing is inevitable—especially for the innovative high-cost technologies and drugs that are the future of medicine.

The Dean of the Harvard Medical School gave it a “failing grade.” Dr. Jeffrey Flier argued that:

In effect, while the legislation would enhance access to insurance, the trade-off would be an accelerated crisis of health-care costs and perpetuation of the current dysfunctional system—now with many more participants. This will make an eventual solution even more difficult. Ultimately, our capacity to innovate and develop new therapies would suffer most of all.

The state’s largest doctors group is opposing healthcare legislation being debated in the Senate this week, saying it would increase local healthcare costs and restrict access to care for elderly and low-income patients.

The California Medical Assn. represents more than 35,000 physicians statewide, making it the second-largest state medical association in the country after Texas. […]

d“The Senate bill came so short that we could not support it, even though we solidly support healthcare reform,” said Dr. Dev GnanaDev, medical director at Arrowhead Regional Medical Center in San Bernardino, who also serves on the association’s executive committee.

Doctors who oppose the Senate bill are concerned that it would would shift Medicare funding from urban to rural areas, move responsibility for Medicare oversight away from Congress by creating an Independent Medicare Commission and, ultimately, decrease Medicare reimbursement rates.

Support for the president’s health care plan fell to 38%, its lowest ever, just before Thanksgiving. Followed by two weeks at 41%, this marks the lowest extended period of support for the plan yet. With the exception of a few days following nationally televised presidential appeals for the legislation, the number of voters opposed to the plan has always exceeded the number who favor it.

“This suggests that public opinion about the health care plan is hardening,” says Scott Rasmussen, president of Rasmussen Reports. “Despite the fact that most American believe our health care system needs major changes, most are opposed to what Congress is currently doing about it.” […]

While one of the chief stated goals of the plan proposed by the president and congressional Democrats is to lower the cost of health care, 57% say costs will go up if the plan is passed. Twenty-one percent (21%) say costs will go down, and 17% believe they will stay about the same.

Similarly, only 23% think the quality of health care will get better if the plan is passed, while 54% predict that it will get worse. Sixteen percent (16%) expect quality to stay about the same.

So what do the Democrats – who promised unprecedented “openness” and “transparency” – do? Barack Obama went to the Senate and had a
“closed-door meeting” that slammed the door shut in Republicans’ faces. This is a hard care ideologically leftist partisan takever, funded by flat-out bribes paid for by the taxpayers.

Speaker Nancy Pelosi has reportedly told fellow Democrats that she’s prepared to lose seats in 2010 if that’s what it takes to pass ObamaCare, and little wonder. The health bill she unwrapped last Thursday, which President Obama hailed as a “critical milestone,” may well be the worst piece of post-New Deal legislation ever introduced.

In a rational political world, this 1,990-page runaway train would have been derailed months ago. With spending and debt already at record peacetime levels, the bill creates a new and probably unrepealable middle-class entitlement that is designed to expand over time. Taxes will need to rise precipitously, even as ObamaCare so dramatically expands government control of health care that eventually all medicine will be rationed via politics.

Yet at this point, Democrats have dumped any pretense of genuine bipartisan “reform” and moved into the realm of pure power politics as they race against the unpopularity of their own agenda. The goal is to ram through whatever income-redistribution scheme they can claim to be “universal coverage.” The result will be destructive on every level—for the health-care system, for the country’s fiscal condition, and ultimately for American freedom and prosperity.

•The spending surge. The Congressional Budget Office figures the House program will cost $1.055 trillion over a decade, which while far above the $829 billion net cost that Mrs. Pelosi fed to credulous reporters is still a low-ball estimate. Most of the money goes into government-run “exchanges” where people earning between 150% and 400% of the poverty level—that is, up to about $96,000 for a family of four in 2016—could buy coverage at heavily subsidized rates, tied to income. The government would pay for 93% of insurance costs for a family making $42,000, 72% for another making $78,000, and so forth.

At least at first, these benefits would be offered only to those whose employers don’t provide insurance or work for small businesses with 100 or fewer workers. The taxpayer costs would be far higher if not for this “firewall”—which is sure to cave in when people see the deal their neighbors are getting on “free” health care. Mrs. Pelosi knows this, like everyone else in Washington.

Even so, the House disguises hundreds of billions of dollars in additional costs with budget gimmicks. It “pays for” about six years of program with a decade of revenue, with the heaviest costs concentrated in the second five years. The House also pretends Medicare payments to doctors will be cut by 21.5% next year and deeper after that, “saving” about $250 billion. ObamaCare will be lucky to cost under $2 trillion over 10 years; it will grow more after that.

• Expanding Medicaid, gutting private Medicare. All this is particularly reckless given the unfunded liabilities of Medicare—now north of $37 trillion over 75 years. Mrs. Pelosi wants to steal $426 billion from future Medicare spending to “pay for” universal coverage. While Medicare’s price controls on doctors and hospitals are certain to be tightened, the only cut that is a sure thing in practice is gutting Medicare Advantage to the tune of $170 billion. Democrats loathe this program because it gives one of out five seniors private insurance options.

As for Medicaid, the House will expand eligibility to everyone below 150% of the poverty level, meaning that some 15 million new people will be added to the rolls as private insurance gets crowded out at a cost of $425 billion. A decade from now more than a quarter of the population will be on a program originally intended for poor women, children and the disabled.

Even though the House will assume 91% of the “matching rate” for this joint state-federal program—up from today’s 57%—governors would still be forced to take on $34 billion in new burdens when budgets from Albany to Sacramento are in fiscal collapse. Washington’s budget will collapse too, if anything like the House bill passes.

• European levels of taxation. All told, the House favors $572 billion in new taxes, mostly by imposing a 5.4-percentage-point “surcharge” on joint filers earning over $1 million, $500,000 for singles. This tax will raise the top marginal rate to 45% in 2011 from 39.6% when the Bush tax cuts expire—not counting state income taxes and the phase-out of certain deductions and exemptions. The burden will mostly fall on the small businesses that have organized as Subchapter S or limited liability corporations, since the truly wealthy won’t have any difficulty sheltering their incomes.

This surtax could hit ever more earners because, like the alternative minimum tax, it isn’t indexed for inflation. Yet it still won’t be nearly enough. Even if Congress had confiscated 100% of the taxable income of people earning over $500,000 in the boom year of 2006, it would have only raised $1.3 trillion. When Democrats end up soaking the middle class, perhaps via the European-style value-added tax that Mrs. Pelosi has endorsed, they’ll claim the deficits that they created made them do it.
Under another new tax, businesses would have to surrender 8% of their payroll to government if they don’t offer insurance or pay at least 72.5% of their workers’ premiums, which eat into wages. Such “play or pay” taxes always become “pay or pay” and will rise over time, with severe consequences for hiring, job creation and ultimately growth. While the U.S. already has one of the highest corporate income tax rates in the world, Democrats are on the way to creating a high structural unemployment rate, much as Europe has done by expanding its welfare states.

Meanwhile, a tax equal to 2.5% of adjusted gross income will also be imposed on some 18 million people who CBO expects still won’t buy insurance in 2019. Democrats could make this penalty even higher, but that is politically unacceptable, or they could make the subsidies even higher, but that would expose the (already ludicrous) illusion that ObamaCare will reduce the deficit.

• The insurance takeover. A new “health choices commissioner” will decide what counts as “essential benefits,” which all insurers will have to offer as first-dollar coverage. Private insurers will also be told how much they are allowed to charge even as they will have to offer coverage at virtually the same price to anyone who applies, regardless of health status or medical history.

The cost of insurance, naturally, will skyrocket. The insurer WellPoint estimates based on its own market data that some premiums in the individual market will triple under these new burdens. The same is likely to prove true for the employer-sponsored plans that provide private coverage to about 177 million people today. Over time, the new mandates will apply to all contracts, including for the large businesses currently given a safe harbor from bureaucratic tampering under a 1974 law called Erisa.

The political incentive will always be for government to expand benefits and reduce cost-sharing, trampling any chance of giving individuals financial incentives to economize on care. Essentially, all insurers will become government contractors, in the business of fulfilling political demands: There will be no such thing as “private” health insurance.
***

All of this is intentional, even if it isn’t explicitly acknowledged. The overriding liberal ambition is to finish the work began decades ago as the Great Society of converting health care into a government responsibility. Mr. Obama’s own Medicare actuaries estimate that the federal share of U.S. health dollars will quickly climb beyond 60% from 46% today. One reason Mrs. Pelosi has fought so ferociously against her own Blue Dog colleagues to include at least a scaled-back “public option” entitlement program is so that the architecture is in place forfuture Congressestoexpand this share even further.

As Congress’s balance sheet drowns in trillions of dollars in new obligations, the political system will have no choice but to start making cost-minded decisions about which treatments patients are allowed to receive. Democrats can’t regulate their way out of the reality that we live in a world of finite resources and infinite wants. Once health care is nationalized, or mostly nationalized, medical rationing is inevitable—especially for the innovative high-cost technologies and drugs that are the future of medicine.

Mr. Obama rode into office on a wave of “change,” but we doubt most voters realized that the change Democrats had in mind was making health care even more expensive and rigid than the status quo. Critics will say we are exaggerating, but we believe it is no stretch to say that Mrs. Pelosi’s handiwork ranks with the Smoot-Hawley tariff and FDR’s National Industrial Recovery Act as among the worst bills Congress has ever seriously contemplated.

In 2008, America voted for national suicide, whether they understood it or not. While it is increasingly obvious that Americans are rethinking their suicide pact with the Democrat Party, and beginning to change their minds, Democrats are nevertheless racing ahead to finish the job of destroying the country while they still can.

Think Cloward-Piven. The Democrats believe that they are creating a “win we win, lose we win” stratagem. If by some increasingly unlikely miracle our massive unprecedented debt-financed spending doesn’t cause the entire economic structure to implode, Democrats will be in a position to claim credit for their “success.” If, far more likely, the economy self-destructs under the weight of the mind-boggling debts and economic hamstringing foisted upon us by the liberal agenda, Democrats are counting upon the fact that hungry, desperate, panicking people will turn to massive government structures to feed them and help them from the very problems that massive government structures caused in the first place.

This is a prepared House Republican document which you can view as a PDF file here.

House Democrat Health “Reform” Legislation: Short Summary of the Government Takeover of Health Care

October 29, 2009

BACKGROUND AND EXECUTIVE SUMMARY
On October 29, 2009, Speaker Pelosi and the House Democrat leadership introduced H.R. 3962, the Affordable Health Care for America Act. The legislation combines provisions in the versions of H.R. 3200, America’s Affordable Health Choices Act, approved by the Committees on Education and Labor, Energy and Commerce, and Ways and Means, as well as other provisions negotiated behind closed doors by the Democrat leadership. The bill is expected on the floor the week of November 2, under a likely structured rule. While press reports indicate the bill will cost at least $894 billion, a CBO score is not yet available, and the following analysis will be updated as events warrant.

Buried within the contents of the 1,990 page bill—as well as a separate 13-page bill (H.R. 3961) that would increase the deficit by more than $200 billion—are details that will see a massive federal involvement in the health care of every American, including the following:

• Creation of a government-run insurance program that could cause as many as 114 million Americans to lose their current coverage;
• Abolition of the private market for individual health insurance, forcing individuals to purchase coverage in a government-run Exchange;
• Stifling insurance regulations that would raise premiums and encourage employers to drop coverage;
• Trillions of dollars in new federal spending that will exacerbate the deficit and imperil the nation’s long-term fiscal solvency;
• Taxes on all Americans—individuals who purchase insurance, individuals who do not purchase insurance, and millions of small businesses—that will kill jobs and raise health care premiums; and
• Cuts to Medicare Advantage plans that will result in higher premiums and dropped coverage for more than 10 million seniors.

SUMMARY OF KEY PROVISIONSThe Government Takeover

Creation of Exchange: The bill creates within the federal government a nationwide Health Insurance Exchange. Uninsured individuals would be eligible to purchase an Exchange plan, as would those whose existing employer coverage is deemed “insufficient” by the federal government. Once deemed eligible to enroll in the Exchange, individuals would be permitted to remain in the Exchange until becoming Medicare-eligible—a provision that would likely result in a significant movement of individuals into the bureaucrat-run Exchange over time. Employers with 25 or fewer employees would be permitted to join the Exchange in its first year, with employers with 25-50 employees permitted to join in its second year. Employers with fewer than 100 employees would be permitted to enroll in the third year, and all employers would also be eligible to join, if permitted to do so by the Commissioner. Many may note the limits on employer eligibility in the first several years are significantly higher than in H.R. 3200, thus expanding the scope of the government-run Exchange.

Exchange Benefit Standards: The bill requires the Commissioner to establish benefit standards for all plans. These onerous, bureaucrat-imposed standards would hinder the introduction of innovative models to improve enrollees’ health and wellness—and by insulating individuals from the cost of health services with restrictive cost-sharing, could raise health care costs.

Government-Run Health Plans: The bill requires the Department of Health and Human Services to establish a “public health insurance option” through the Exchange. The bill states the plan shall comply with requirements related to other Exchange plans. Empowered to collect individuals’ personal health information, with access to federal courts for enforcement actions and $2 billion in “start-up funds”—as well as 90 days’ worth of premiums as “reserves”—from the Treasury, the bill’s headings regarding a “level playing field” belie the reality of the plain text. In addition, the bill requires the Secretary to establish premium rates that can fully finance the cost of benefits and administrative costs, but there would always be the implicit backing of the federal government.

The bill provides that the government-run plan shall enlist all Medicare providers unless physicians affirmatively decide to opt-out of the program. While the Secretary will be required to “negotiate” reimbursement rates with doctors and hospitals, nothing in the bill prohibits the Secretary from using such negotiation to impose Medicare reimbursement levels on providers as part of a government-imposed “negotiation.” Should such a scenario occur, the Lewin Group has estimated that as many as 114 million individuals could lose access to their current coverage under a government-run plan—and that a government-run plan reimbursing at the rates contemplated by the legislation would actually result in a net $16,207 decrease in reimbursements per physician per year, even after accounting for the newly insured.

The bill requires the Secretary to “establish conditions of participation for health care providers” under the government-run plan—however it includes no guidance or conditions under which the Secretary must establish those conditions. Many may be concerned that the bill would allow the Secretary to prohibit doctors from participating in other health plans as a condition of participation in the government-run plan—a way to co-opt existing provider networks and subvert private health coverage.

“Low-Income” Subsidies: The bill provides subsidies only through the Exchange, again putting employer health plans at a disadvantage. Individuals with access to employer-sponsored insurance whose group premium costs exceed 12 percent of adjusted gross income would be eligible for subsidies.

The bill provides that the Commissioner may authorize State Medicaid agencies—as well as other “public entit[ies]”—to make determinations of eligibility for subsidies and exempts the subsidy regime from the five-year waiting period on federal benefits established as part of the 1996 welfare reform law (P.L. 104-193). The second provision would give individuals a strong incentive to emigrate to the United States in order to obtain subsidized health benefits without a waiting period. Despite the bill’s purported prohibition on payments to immigrants not lawfully present, and the insertion of a citizenship verification provision, some may be concerned that the provisions as drafted would not require individuals to verify their identity when confirming eligibility for subsidies—encouraging identity fraud while still permitting undocumented immigrants and other ineligible individuals from obtaining taxpayer-subsidized benefits.

Premium subsidies provided would be determined on a six-tier sliding scale, such that individuals with incomes under 133 percent of the Federal Poverty Level (FPL, $29,327 for a family of four in 2009) would be expected to pay 1.5 percent of their income, while individuals with incomes at 400 percent FPL ($88,200 for a family of four) would be expected to pay 12 percent of their income. Subsidies would be based on adjusted gross income (AGI), meaning that individuals with total incomes well in excess of the AGI threshold could qualify for subsidies.

The bill further provides for cost-sharing subsidies, such that individuals with incomes under 133 percent FPL would be covered for 97 percent of expenses, while individuals with incomes at 400 percent FPL would have a basic plan covering 70 percent (the statutory minimum). These rich benefit packages, in addition to raising subsidy costs for the federal government, would insulate plan participants from the effects of higher health spending, resulting in an increase in overall health costs—exactly the opposite of the bill’s purported purpose.

Medicaid Expansion: The bill would expand Medicaid to all individuals with incomes under 150 percent of the federal poverty level ($33,075 for a family of four). Under the bill, the bill’s expansion of Medicaid to more than 10 million individuals would be fully paid for by the federal government only through 2014—thus imposing billions in unfunded mandates on States, which would be expected to pay nearly 10 percent of the cost of the expansion beginning in 2015.

Benefits Committee: The bill establishes a new government health board called the “Health Benefits Advisory Committee” to make recommendations on minimum federal benefit standards and cost-sharing levels. The Committee would be comprised of federal employees and Presidential appointees.

The bill eliminates language in the discussion draft of H.R. 3200 stating that Committee should “ensure that essential benefits coverage does not lead to rationing of health care.” Many view this change as an admission that the bureaucrats on the Advisory Committee—and the new government-run health plan—would therefore deny access to life-saving services and treatments on cost grounds. As written, the Committee could require all Americans to obtain health insurance coverage of abortion procedures as part of the bill’s new individual mandate.

Funneling Patients into Government Care

Abolition of Private Insurance Market: The bill imposes new regulations on all health insurance offerings, with only limited exceptions. Existing individual market policies could remain in effect—but only so long as the carrier “does not change any of its terms and conditions, including benefits and cost-sharing” once the bill takes effect. With the exception of these grandfathered individual plans subject to numerous restrictions, insurance purchased on the individual market “may only be offered” until the Exchange comes into effect, thus abolishing the private market for individual health insurance and requiring all non-employer-based coverage to be purchased through the bureaucrat-run Exchange.

Employer coverage shall be considered exempt from the additional federal mandates, but only for a five year “grace period”—after which all the bill’s mandates shall apply. By applying new federal mandates and regulations to employer-sponsored coverage, this provision would increase health costs for businesses and their workers, encourage employers to drop existing coverage, and leave employees to access care through the government-run Exchange.

“Pay-or-Play” Mandate on Employers: The bill requires that employers offer health insurance coverage, and contribute to such coverage at least 72.5 percent of the cost of a basic individual policy—as defined by the Health Benefits Advisory Council—and at least 65 percent of the cost of a basic family policy, for full-time employees. The bill further extends the employer mandate to part-time employees, with contribution levels to be determined by the Commissioner, and mandates that any health care contribution “for which there is a corresponding reduction in the compensation of the employee” will not comply with the mandate—which would encourage them to lay off workers.

Employers must comply with the mandate by “paying” a tax of 8 percent of wages in lieu of “playing” by offering benefits that meet the criteria above. In addition, beginning in the Exchange’s second year, employers whose workers choose to purchase coverage through the Exchange would be forced to pay the 8 percent tax to finance their workers’ Exchange policy—even if they offer coverage to their workers.

The bill includes a limited exemption for small businesses from the employer mandate—those with total payroll under $500,000 annually would be exempt, and those with payrolls between $500,000 and
$750,000 would be subjected to lower tax penalties (2-6 percent, as opposed to 8 percent for firms with payrolls over $750,000). However, these limits are not indexed for inflation, and the threshold amounts would likely become increasingly irrelevant over time, meaning virtually all employers would be subjected to the 8 percent payroll tax.

The bill amends ERISA to require the Secretary of Labor to conduct regular plan audits and “conduct investigations” and audits “to discover non-compliance” with the mandate. The bill provides a further penalty of $100 per employee per day for non-compliance with the “pay-or-play” mandate—subject only to a limit of $500,000 for unintentional failures on the part of the employer.

The employer mandate would impose added costs on businesses with respect to both their payroll and administrative overhead. An economic model developed by Council of Economic Advisors Chair Christina Romer found that an employer mandate could result in the loss of up to 5.5 million jobs as employers lay off employees to avoid providing costly, government-forced health insurance.

Individual Mandate: The bill places a tax on individuals who do not purchase “acceptable health care coverage,” as defined by the bureaucratic standards in the bill. The tax would constitute 2.5 percent of adjusted gross income, up to the amount of the national average premium through the Exchange. The tax would not apply to dependent filers, non-resident aliens, individuals resident outside the United States, and those exempted on religious grounds. “Acceptable coverage” includes qualified Exchange plans, “grandfathered” individual and group health plans, Medicare and Medicaid plans, and military and veterans’ benefits.

For individuals with incomes of under $100,000, the cost of complying with the mandate would be under $2,000—raising questions of how effective the mandate will be, as paying the tax would in many cases cost less than purchasing an insurance policy. Despite, or perhaps because of, this fact, the bill language does not include an affordability exemption from the mandate; thus, if the many benefit mandates imposed raise premiums so as to make coverage less affordable for many Americans, they will have no choice but to pay an additional tax as their “penalty” for not being able to afford coverage. Then-Senator Barack Obama, pointed out in a February 2008 debate that in Massachusetts, the one State with an individual mandate, “there are people who are paying fines and still can’t afford [health insurance], so now they’re worse off than they were. They don’t have health insurance and they’re paying a fine.”

Medicare Advantage: The bill reduces Medicare Advantage (MA) payment benchmarks to levels paid by traditional Medicare—which provides less care to seniors—over a three-year period. This arbitrary adjustment would reduce access for millions of seniors to MA plans that have brought additional benefits.

The bill imposes requirements on MA plans to offer cost-sharing no greater than that provided in government-run Medicare, and imposes price controls on MA plans, limiting their ability to offer innovative benefit packages. This policy would encourage plans to keep seniors sick, rather than manage their chronic disease.

The bill also gives the Secretary blanket authority to reject “any or every bid by an MA organization,” as well as any bid by a carrier offering private Part D Medicare prescription drug coverage, giving federal bureaucrats the power to eliminate the MA program entirely—by rejecting all plan bids for nothing more than the arbitrary reason that an Administration wishes to force the 10 million beneficiaries enrolled in MA back into traditional, government-run Medicare against their will.Tax Increases

Government-Forced Insurance Penalties: Offsetting payments to finance the government takeover of health care would include taxes on individuals not complying with the mandate to purchase coverage, as well as taxes and payments by businesses associated with the “pay-or-play” mandate.

Taxes on Small Businesses: The bill also imposes a new 5.4 percent “surtax” on individuals with incomes over incomes over $500,000 and families with incomes greater than $1 million. The tax would apply beginning in 2011. As more than half of all high-income filers are small businesses, this provision would cripple small businesses and destroy jobs during a deep recession.

Taxes on Health Plans: The bill prohibits the reimbursement of over-the-counter pharmaceuticals from Health Savings Accounts (HSAs), Medical Savings Accounts, Flexible Spending Arrangements (FSAs), and Health Reimbursement Arrangements (HRAs), and increases the penalties for non-qualified HSA withdrawals from 10 percent to 20 percent, effective in 2011. Because these savings vehicles are tax-preferred, adopting this prohibition would raise taxes by $8.2 billion over ten years, according to the Joint Committee on Taxation.

H.R. 3962 would place a cap on FSA contributions, beginning in 2012; contributions could only total $2,500 per year, subject to annual adjustments linked to the growth in general (not medical) inflation. Members may be concerned that these provisions would first raise taxes, and second—by imposing additional restrictions on health savings vehicles popular with tens of millions of Americans—undermines the promise that “If you like your current coverage, you can keep it.” At least 8 million individuals hold insurance policies eligible for HSAs, and millions more participate in FSAs. All these individuals would be subject to additional coverage restrictions—and tax increases—under this provision.

The bill also repeals the current-law tax deductibility of subsidies provided to companies offering prescription drug companies to retirees. Many may be concerned that this provision would lead to companies dropping their current coverage as a result.

Taxes on Health Products: Finally, H.R. 3962 would impose a 2.5 percent excise tax on medical devices, beginning in 2013. Many may echo the concerns of the Congressional Budget Office and other independent experts, who have confirmed that this tax would be passed on to consumers in the form of higher prices—and ultimately higher premiums.Budgetary Gimmicks

Unpaid-For Doctor Fix: While the Democrats claim their bill is now deficit-neutral, the majority also introduced a separate piece of stand-alone legislation (H.R. 3961). The more than $200 billion cost of this legislation is not paid for, thus adding hundreds of billions of dollars in deficit spending and interest costs to the federal debt. Many may also note that the Congressional Budget Office recently analyzed similar legislation (S. 1776) as raising Medicare premiums by $70 billion.

Long-Term Care Program: The bill includes a new program for long-term care services that provides a benefit of at least $50 per day to individuals unable to perform certain functions of daily living. As the long-term care program requires individuals to contribute five years’ worth of premiums before becoming eligible for benefits, the program would find its revenue over the first ten years diverted to finance other spending in Democrats’ health care “reform.” However, the Congressional Budget Office, in analyzing similar provisions included in Section 191 of legislation considered by the Senate HELP Committee, found that “if the Secretary did not modify the program to improve its actuarial soundness, the program would add to future federal budget deficits in a large and growing fashion beginning a few years beyond the 10-year budget window.” As even Democrats such as Senate Budget Committee Chairman Kent Conrad (D-ND) have called the program a “Ponzi scheme,” many may find any legislation that relies upon such a program to maintain “deficit-neutrality” fiscally irresponsible and not credible.

The purpose of this amendment is simple. If the secretary of Health and Human Services certifies that more than 1 million Americans would lose the current coverage of their choice because of this bill, then this bill would not go into effect.

It seems like a very, very simple but perfect amendment for those of us who have integrity. This amendment is simply trying to safeguard President Obama’s pledge to the American people, you’ll get — that you will get to keep what you have.

And the Democrats failed the test.

Every single Democrat in the Finance Committee voted against it. Every single one.

One of President Obama’s mantras with regard to the Democrats’ health care proposal (whatever it turns out to be) is that if you like your present health insurance coverage, you will get to keep it. More recently, when the fraudulent nature of that pledge was revealed, he changed the formula to “the bill won’t require you to lose your coverage.” That’s right; it won’t require you to lose your coverage, it will just cause you to lose your coverage.

Don’t think for a second Democrats and President Obama don’t know what a pack of liars they are.

Last Sunday, Barack Obama proved that he is a liar by refusing to call what is clearly a tax a tax. And Obama’s own hometown newspaper proves the obvious.

Last Tuesday, the Democrat-approved Congressional Budget Office laid out Obama’s lie that Medicare would not be cut:

The head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, told senators that seniors in Medicare’s managed care plans could see reduced benefits under a bill in the Finance Committee.

The bill would cut payments to the Medicare Advantage plans by more than $100 billion over 10 years.

The Democrats’ shocking deceit – and Barack Obama’s own personal deceptions and lies – are incredible. They will literally say ANYTHING to get their terrible plan passed.

Please don’t trust these liars to take over 1/6th of the U.S. economy during a period when the economy is already in deep trouble. And please don’t turn the lives of seniors over to a plan that will literally kill many of them.